energy for the “uphill” transport of the other solute(s).

c. Metabolic energy is not provided directly but indirectly from

the Na+

gradient that is maintained across cell membranes. Thus, inhibition

of

Na+, K+-ATPase will decrease transport of Na+ out of the

cell, decrease

the transmembrane Na+ gradient, and eventually inhibit secondary

active transport.

d. If the solutes move in the same direction across the cell

membrane, it is

called cotransport or symport.

Examples are Na+-glucose cotransport in the small intestine and

renal

early proximal tubule and Na+–K+–2Cl– cotransport in the renal thick

ascending limb.

e. If the solutes move in opposite directions across the cell

membranes, it

is called countertransport, exchange, or antiport.

Examples are Na+-Ca2+ exchange and Na+–H+exchange.

2. Example of Na+–glucose cotransport (Figure 1.1)

a. The carrier for Na+–glucose cotransport is located in the luminal

membrane of intestinal mucosal and renal proximal tubule cells.

b. Glucoseis transported “uphill”; Na+ is transported “downhill.”

c. Energy is derived from the “downhill” movement of Na+. The

inwardly

directed Na+ gradient is maintained by the Na+–K+ pump on

the

basolateral (blood side) membrane. Poisoning the Na+–K+ pump

decreases the transmembrane Na+ gradient and consequently inhibits

Na+–glucose cotransport.

3. Example of Na+–Ca2+ countertransport or exchange (Figure

1.2)

a. Many cell membranes contain a Na+–Ca2+ exchanger that

transports

Ca2+ “uphill” from low intracellular [Ca2+] to high extracellular [Ca2+].

Ca2+ and Na+ move in opposite directions across the cell

membrane.

b. The energy is derived from the “downhill” movement of Na+.

As with

cotransport, the inwardly directed Na+ gradient is maintained

by the

Na+–K+ pump. Poisoning the Na+–K+ pump therefore inhibits Na+–

Ca2+ exchange.